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In the absence of any evidence showing there is any difference in mortality or morbidity between Physician Anesthesiologist (MDA) care and Certified Registered Nurse Anesthetist (CRNA) anesthesia care some MDAs have opted to stoop to a new low.

American Society of Anesthesiologist (ASA) President Dr. Jeff Plagenhoef recently sent out an email to all members of the ASA imploring them to fill out a SURVEY comparing Certified Registered Nurse Anesthetist (CRNAs) and Anesthesiologist Assistants (AAs) when under medical direction.
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CRNAs: A short history of nurse anesthesia and the future of anesthesia care.

What's old is new again. I have always had a keen interest in anesthesia history and as a resident in anesthesia, presented some articles and papers for the International Anesthesia History Association on Chauncey Leake and the development of divinyl ether and at the Anesthesia History Association here in the US on Sir William Macewen and early attempts at intubating patients under general anesthesia. I am a firm believer, as a scientist, clinician and physician leader, that one must truly
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Is a dental practice liable if a patient is sexually assaulted by a contractor while under anesthesia? The Georgia Supreme Court recently decided, in the case of Goldstein Garber & Salama v. J.B., that it is not.

Dr. Caren Cajares is a CRNA currently practicing independently in the seven cities that make up
Tidewater, VA. She provides anesthesia services for plastic surgeons, gastroenterologists,
ophthalmologists, oral surgeons, and partners with a dentist in a specialized practice. She is a
veteran of the United States Army, which she includes among her greatest
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Mary Frances Mullins DNP CRNA graduated in June 2016 from Grand Canyon University with her Doctor of Nursing Practice (DNP) degree. In 2001, she graduated from the Uniformed Services University in Bethesda with an MSN in nurse anesthesia. She also holds CPAN and CAPA certification and currently works at Memorial Medical Center in Modesto, CA

Abstract
Nearly 25 million people in the United States suffer from obstructive sleep apnea (OSA). This serious under-recognized, under-diagnosed medical disorder is associated with significant comorbidities as well as increased perioperative risks. Therefore, preoperative screening for OSA using a validated OSA screening tool such as the STOP-Bang OSA screening questionnaire is imperative. Using a quantitative methodology with a comparative design, this author observed for statistically significant differences in the proportion of postoperative hypoxemia between two sample groups. Group A (n=100) was comprised of adult (ages 18-75) general anesthesia elective surgery patients who were screened preoperatively for OSA on the STOP-Bang OSA screening instrument. Group B (n=100) was comprised of adult (ages 18-75) general anesthesia elective surgery patients who were not screened preoperatively for OSA on the STOP-Bang OSA screening instrument. A Chi-square analysis was conducted comparing the proportion of positive postoperative hypoxemia occurrences in the Post Anesthesia Care Unit (PACU). The proportion of patients who experienced hypoxemia in the PACU pre implementation of the STOP-Bang screening program was not equal to the proportion of patients who experienced hypoxemia in the PACU post implementation of the program, χ2 (1, N = 94) = 2.085, p = .149. This was statistically nonsignificant, but clinically relevant. Clinician awareness of the potential existence of OSA can guide the perioperative care plan to safely meet the special needs of surgical patients with OSA.

Table 1. Descriptive Statistics of Demographic Variables.................................................. 70
Table 2. Pearson Chi-Square Goodness of Fit Between Implementation of the STOP-Bang Screening Program and Proportion of Patients who Experience Hypoxemia in the PACU................ 73

Mark Giles, DNP, CRNA is a 2016 graduate of Quinnipiac University, Hamden, Connecticut, post master's program. He is a staff CRNA at Yale New haven Hospital, New Haven, Connecticut, and an adjunct faculty member at Quinnipiac University.

This is the final submission of National University's Jonathan Gardner's Scholarly Project. He is a Nurse Anesthesia Resident at National University.

In Adult Patients Undergoing Total Knee Arthroplasty How Does The Adductor Canal Block As Compared To The Femoral Nerve Block Affect Postoperative Morbidity?

Abstract:

By the year 2030 the demand for primary total knee arthroplasty (TKA) is projected to grow by 673% to 3.48 million procedures. The anesthetic management for TKA has profound and distinct effects on recovery and rehabilitation, with multiple anesthetic options available for perioperative management. We set out to answer the question “In adult patients undergoing total knee arthroplasty how does the adductor canal block as compared to the femoral nerve block effect postoperative morbidity?”

A comprehensive review of the literature was conducted for comparing adductor canal block (ACB) to femoral nerve block. One meta-analysis, 8 randomized controlled trials and 3 retrospective cohort studies were included with a date range from 2013-2015. Current literature demonstrates that adductor canal blocks are equal to, if not superior
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The shoulder joint is the most flexible joint in the human body; therefore, it is more susceptible to injury than others.1 Surgical interventions may sometimes be performed depending on the nature of the injury. A comprehensive analysis of the epidemiology of shoulder surgeries is beyond the scope of this report. Moreover, the variations in shoulder surgeries based on the type of injury being corrected, the facility setting, and reimbursement
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Over the years many Anesthesiologist Assistants (AAs) have contacted us about a possible AA to CRNA bridge program. Though this option does not currently exist the idea has been bantered around the CRNA community now for many years and the discussion is often
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This last week the Vice President and Executive Editor of Audio Digest, Lon Osmond sent out a letter which angered and disenfranchised 50,000 Nurse Anesthetists. The letter was an apology to Physician Anesthesiologist
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Playing with iPads before surgery could replace sedatives for children. Researchers in France who measured the effect of iPads on child and parent anxiety prior to administering anesthesia to the children
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Historically, in some settings, publications, policies and law, the Certified Registered Nurse Anesthetist (CRNA) has been referred to as a “midlevel provider” or “physician extender.” These and other terms are
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